Eye Pain and Tears: Questions on Glaucoma and Vision Health

Following up on the previous question, I would like to ask the doctor?

Regardless of location and time, I experience eye pain and tearing.
I have a history of glaucoma and dry eye syndrome.
When I was initially diagnosed with glaucoma, my intraocular pressure was not high (though it occasionally was).
My doctor advised me to start using glaucoma medication and to have visual field tests every six months.
During these tests, issues were found in certain angles, and I continued the glaucoma medication.
After about a year, I had another visual field test and a fundus examination, which revealed signs of optic nerve atrophy.
These tests were conducted approximately 2 to 3 years ago.
What is the likelihood of misdiagnosis or suspicion of glaucoma in such cases?
I apologize if this is offensive, but I have been an asthmatic since childhood and have been using asthma medication for about eleven years—six years in elementary school, three years in junior high, and two years in high school.
I have stopped medication for a year and a half, but I have not ceased using asthma medication.
I am unsure if the medications I have taken could cause optic nerve atrophy.
I am sensitive to light and tear easily.
My ophthalmologist advised me to wear dark lenses when going outside.
I stopped my asthma medication a year and a half ago on my own because I wanted to find a way to live without relying on medication.
I am a patient with poorly controlled asthma, which is why my doctor has restricted me from climbing mountains over 2,000 meters and imposed other limitations.

I would like to ask you: Do I still need to return to the ophthalmologist for follow-up regarding my glaucoma?

Doris, 30~39 year old female. Ask Date: 2009/05/21

Dr. Wang Zhishun reply Ophthalmology

Hello! In fact, asthma medications can cause elevated intraocular pressure, typically due to steroid inhalers or oral medications.
However, this does not necessarily mean that the medication should be discontinued.
It should be assessed by both an internist and an ophthalmologist to achieve an optimal balance.
If your glaucoma examination was conducted 2 to 3 years ago, it is advisable to have a follow-up.
The diagnosis and treatment of glaucoma often require time, and this is not something that can be rushed.
I hope this information is helpful to you.

Reply Date: 2009/05/21

More Info

Understanding eye pain and excessive tearing can be complex, especially for someone with a history of glaucoma and dry eye syndrome. Your concerns about the potential misdiagnosis of glaucoma and the implications of your asthma medication on your eye health are valid and deserve careful consideration.

First, regarding the diagnosis of glaucoma, it is important to note that glaucoma can sometimes be challenging to diagnose accurately. The condition is characterized by damage to the optic nerve, often associated with elevated intraocular pressure (IOP). However, some patients can have normal IOP and still develop glaucoma, known as normal-tension glaucoma. The risk of misdiagnosis can depend on various factors, including the thoroughness of the eye examinations, the experience of the ophthalmologist, and the specific tests performed. Regular monitoring through visual field tests and optic nerve assessments is crucial for managing glaucoma effectively. If you have been diagnosed with glaucoma and have a history of visual field loss, it is essential to continue regular follow-ups with your eye care provider to monitor any changes in your condition.

Regarding your concerns about the medications you have taken for asthma, it is unlikely that asthma medications would directly cause optic nerve damage or contribute to glaucoma. However, some medications can have side effects that may affect your eyes, such as causing dry eyes or increased sensitivity to light. If you have stopped your asthma medications and are experiencing symptoms like light sensitivity and excessive tearing, it may be worth discussing these symptoms with your healthcare provider. They can help determine if these symptoms are related to your previous medication or if they are indicative of another underlying issue.

Your experience of eye pain and tearing could also be related to dry eye syndrome, which is common among individuals with a history of allergies or asthma. Dry eyes can lead to discomfort, a sensation of grittiness, and excessive tearing as the eyes attempt to compensate for the lack of moisture. Using lubricating eye drops can help alleviate these symptoms. Additionally, wearing sunglasses or protective eyewear outdoors can help reduce light sensitivity and discomfort.

In terms of your question about whether you should continue to see an eye doctor for glaucoma management, the answer is yes. Even if your IOP is currently within normal limits, the history of optic nerve damage and visual field loss necessitates ongoing monitoring. Regular eye exams are essential for detecting any progression of the disease and adjusting treatment as needed. If you have concerns about your current treatment plan or the frequency of your visits, it is advisable to discuss these with your ophthalmologist. They can provide personalized recommendations based on your specific situation.

In summary, it is crucial to maintain regular follow-ups with your eye care provider to monitor your glaucoma status and address any new symptoms you may experience. Additionally, managing your dry eye symptoms and protecting your eyes from excessive light exposure can improve your overall comfort. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for guidance. Your eye health is an integral part of your overall well-being, and proactive management is key to maintaining it.

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